Provider Demographics
NPI:1609511211
Name:NEEL, DIANNA LOIS
Entity Type:Individual
Prefix:
First Name:DIANNA
Middle Name:LOIS
Last Name:NEEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 E JAMES FUNK RD
Mailing Address - Street 2:
Mailing Address - City:LAKE ARTHUR
Mailing Address - State:NM
Mailing Address - Zip Code:88253-9707
Mailing Address - Country:US
Mailing Address - Phone:575-308-9704
Mailing Address - Fax:
Practice Address - Street 1:7044 99TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-7930
Practice Address - Country:US
Practice Address - Phone:575-308-9704
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-28
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider